? Insulin dosage ?

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icesnow

icesnow

Member Since 2015
Hi, i have a question about insulin dosage. My cat Belle previously (last time was over a month ago) had glucose curve done at the vet, and they said his number averages at 400s. I was instructed to give him 4 units twice a day (that is 8 units a day), with Lantus.
Now that I learned I can home test him, I just bought the kit and tested him today at 530pm (I wasn't able to do the curves becos of several failures earlier today, his insulin was given at 1130am), and his number is 102 !!! so, i know i shouldn't be giving him 4 units any more, but what should be the dosage to give him?
 
Hi Helena and glad to see you over here from the Facebook group!! 102 isn't a medical emergency, so it's OK to go back and "edit" your subject line and remove the 911...our hearts skip a beat or two every time we see that!

4 units is a VERY high dose! It looks like your vet doesn't know how to dose when it comes to Lantus and Belle may very well be getting way too much insulin already!

Generally, we start out at .5 to 1U and go up slowly to make sure we don't go past what might be a "best dose" for each cat.

Cats that are only tested at the vets are under stress which can raise their blood glucose up to 200 points so it's great that you're learning to home test now!

What are you feeding Belle?? What meter are you using?
 
I'm sorry I don't give dosing advice but thank goodness you learned to test. I hope someone more experienced will be along soon to answer your question.

In the meantime, can you tell us a little about what Belle is eating? Did he start at 4 units or have they moved him up?

Also can you tell us what meter you are using?
 
My "do not shoot" dose was 250 when I first started. Later, after much data collection of his response to foods & meds, I was able to shoot lower numbers. If you decide to shoot, I would only do a very "token dose", such as the .5u that Chris suggested above, then test throughout the cycle to see where she goes. Data / aka knowledge is power.
 
Ahhh... I see from Facebook that you're feeding Purina DM...is that the dry or the canned?

The dry is too high in carbs for our diabetics...the canned is OK, but it's very expensive and no better than a lot of the foods you can buy at any WalMart or grocery store for a lot less money
 
In reply to Chris & China and Brashworks
@Chris & China @Brashworks

Belle had been on Purina DM (can and dry), and also getting some fancy feast lately (after i read from the FB page)
i know it's best if he only eats canned food; but he could not just be on canned , as he eats throughout the day, and i am not always there to give him food. And i am afraid he will go off and beg for food from neighbors.

A little background of Belle: he was an abandoned from neighbor, him and his sister came to me quite a few years ago ( (i just found out they are siblings from that neighbor who abandoned them) . But since i already have pets at home, i can only offer for him to stay in the garage at night. And he goes out during the day, which he wants to go out, he enjoys the sun and the grass. But the thing is, since he is with his sister Bailey, they eat together, and there are other cats who come to eat as well; it also becomes difficult to offer just canned food.

As for the meter, I am using the ReliOn micro.

His vet keep increasing his dosage, we started out with 2, then she increased it to 3, then to 4.

 
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Hey @icesnow - my Billy is a grazer too. He eats canned food all day and night. He doesn't overeat or undereat so I just put out a 3oz can in the morning and a 3oz can at night. Sometimes he doesn't finish and the leftovers go to the dog. I have other pets as well, and Billy gets "freedom or food". He's always crying for one or the other. I sequester him for feeding during the day and give him freedom when I come home, and then at night I put his food in my bedroom and shut him in with me. I guess your guy is in the garage, he can have his canned in there? Find a spot separate from the sister or feed the sister canned too? You don't need expensive food at all. Friskies, Fancy Feast, and other low cost brands have low carb varieties (research these before buying, basically no gravy or shredded, only pate) and they're cheap. You can stock up on the large size cans when on sale.
 
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It's so nice you are treating his diabetes despite not having room in the house for him <3 Good for you. Good luck!
 
OK...first, we use a spreadsheet here that is every bit as valuable a tool as your meter and insulin for helping Belle. Here are Instructions for getting the spreadsheet....if you have trouble, let us know so we can help you!!

As long as he's going out every day and can get into other foods, it's going to be MUCH harder to get his diabetes under control....you don't have to stay home all day to feed him (we have lots of tricks) but if he's able to get to dry food outside, you can be sure he's going to.

If I were you, I'd probably drop back in dose and start getting some testing in....ALWAYS before shots (the "Pre-shot tests") and then IF YOU CAN a mid-cycle test on the AM cycle (around 5-7 hours after the shot.....what we call +5 to +7) and a "before bed" test on the PM cycle. If you can't get mid-cycle tests on the AM cycle, then getting tests on the PM cycle are even more important.

As long as he's eating dry food, the only method you can use is called "Start Low, Go Slow" . The usual starting dose is .5 to 1U....since he's been on 4 already, I'd probably suggest starting at 1 Unit. On SLGS, you hold the dose for 7 days and then do a "curve" (every 2 hour tests for 12 hours or every 3 hours for 18 hours) and then we decide if he needs to increase or not. If he drops below 90 at any time, we'd reduce his dose too!

Has he ever been diagnosed with ketones?

It'll also really help if you'll go ahead and add some information to your signature (if you look below my comment, you'll see the info I have in mine for China) Just click on your sign on name on the top right of the page and choose "signature"...a new box will pop up and you can add the information (and the link to your spreadsheet when you have it)

Some of the info to add is your name/cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food and any other health problems Belle has....a general idea of where you live is nice to know to!
 
@Kiara
my other cats are on science diet mature adult. they used to be on Friskies/Fancy Feast b4, but i was told those hv too much fat for senior cats. All of them are 10+

@Chris & China

thanks, i will look into the spreadsheet info in a little bit and reply again on that

i believe someone on FB from another post suggested the YoungAgain zero carb dry food. But it's very pricey.

as Belle is older now, he doesn't go outside the yard much anymore, he mostly stays inside the yard, but there are moments that i can't find him. so, in a sense, i don't think he goes outside to eat anymore, but i m afraid, if i don't hv food out for him, he might go.

i did tried to test him b4 giving insulin this morning, but failed (doing it 1st time...) couldn't get enough blood...

As you advice, i will lower his dosage to 1 unit starting tonite. However, someone (i think on FB) said something about the effect of insulin stays for 18 hrs, so his number of 102 might be an effect of his insulin as well?

i m not sure if he had been diagnosed with ketones, as least not that i m aware of

i will figure out on the signature later
 
Yeah, the Young Again is high, but a lot of people use it and say that the cats eat very little of it....You might call the company and get some samples...see if Belle even likes it first (they are happy to send samples!)

Another dry some people use that's lower carb is Evo Cat & Kitten...again, it's not cheap, but it's lower carb than other dry foods

You can leave wet out all day too! A lot of people just add extra water to keep it from drying out (which is also good for their kidneys...any extra water is good!) or you can make "food-sicles" by adding water to canned and freezing it in ice cube or mini-muffin trays. Most cats won't eat it frozen (although some will!) but when it thaws out several hours later, it's just like leaving out fresh food.

Another popular thing around here are auto feeders that you can set to open to offer food anytime you want them to have it like the Petsafe2 or Petsafe5

If you don't get blood, try 3 times and then take a break for a few minutes...it's going to be really important for you to always test before shooting because it's the only way to know if it's safe to give any insulin at all!! A doctor would never tell you to give insulin to a child without knowing what their blood glucose was first, and it's the same for our sugarcats.

Make sure to warm his ear a little before poking. A small sock with some rice in it and microwaved or a small pill bottle filled with warm water work well to warm the ear and bring blood flow into it
 
thanks.

it's a lot of overwhelming info to me right now... i m still reading the spreadsheet info...

the thing is, he is outside during the day, and with his sister there, and other cats coming to eat, if i leave canned food out, it will be gone in no time. he will eat any amount of canned food all at once... and with the auto timer feeder, he might not be around when it opens up and other cats might eat the food instead of him.

yea, (after seeing it in the group on FB), i used the rice sock and was able to get some blood from him finally at 530pm, but missed the morning time.. which i had 3 failures...
 
@Chris & China
One of the members in one of those posts on FB points out that the meter we used are for humans, and the readings are different from the meter from the vet. Pls advice.

she wrote: "I want to add one thing. Take your meter to the vet and compare. I was getting readings in the 100s, and wasn't dosing my guy. At the vet he started reading high. I brought my meter in to compare and the alphatrak was 361 and mine was 166. The next week, they ran on their other machine, the alphatrak, AND my monitor. Alpha trak said 320ish, blood test system said 332 and my monitor said 170-something."
 
Yes...human meters read lower than the AlphaTrak does, but the protocols here are all based on human meters so we're VERY used to them!

ANY meter can be up to 20% off....The FDA allows that much of a variance.

The biggest problem with the AT is that the strips you use in it can be over $1 EACH....when you test 4 or more times a day, that runs into a lot of money that most people can't afford...and that can cause them to not test enough (or go broke....lol)

The human meters like the Relion Confirm/Micro are only .36 cents per strip....and the Prime meter are even cheaper at .18 cents per strip (but the Prime takes a larger sample size and some people have problems with getting error messages with the Prime)

What we watch for mostly here are "patterns" more than the exact numbers....Is the dose getting them down into good numbers? That's what we want!
 
Thank you @Chris & China

did you see my other message b4 the last one ?
"the thing is, he is outside during the day, and with his sister there, and other cats coming to eat, if i leave canned food out, it will be gone in no time. he will eat any amount of canned food all at once... and with the auto timer feeder, he might not be around when it opens up and other cats might eat the food instead of him."

yes, i got the ReliOn micro becos it requires a smaller amount of blood, getting blood from Belle is so difficult, he moves around and won't stay still, can't get much blood out of him to start with, and then all the blood absorb into the fur on his ear...

thank you so much for figuring out the dosage for Belle, i will probably try to do the curve again after the holiday... but it might be challenging, since i tried to do it today, but failed, and was only able to get one reading

btw, if u look at the photo on the left, Belle is one in the lower right hand corner
 
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Awwww...he's very pretty!!! How did a boy kitty get a name like "Belle"?

Keep poking!! As you poke more often, the ears grow new capillaries and make the ears bleed easier!

Not sure what you can do about the food problem if you are going to let Belle continue to go outside since there's no way to keep him out of food he shouldn't get into other than to try using one of the lower carb dry foods

1 unit may not be enough....we won't know until you start getting some tests in so we can see how he's doing. Lantus dosing is based on how LOW it takes them, so it's really important to get some tests in mid-cycle when you can
 
hello dear!!

Im also kind of new here on the forum. Im originally from Argentina.

About food, you will need I guess, to figure out how to feed him during the day. High glucose is bad, but low glucouse can be very dangerous, so food is very important. One good thing is that you changed the dose. This is very important, 4+4 units is too much. So now, this new dosing will be much easier.

On the other hand with high glucose probably the cat will come back requesting for food, since diabetes makes them feel much more hungry. Hope he comes back for food during the day so you can feed him and avoid low glucose.

You need to know when is his nadir (the peak of insulin effect, when glucos reaches the lowest number). Usually Lantus can have a nadir arround + 6 (this means 6 hours after shot). You will know this by doing a curve, this means testing every 2 hours.

And food change is the most important!! Im a raw feeder, since I live in Argentina and we don't have good quality low carb canned food, I use raw meat and bones. We call it barf (biologically apropriate raw food). But bear in mind that whenever you start givin low carb food, you need to be very carefull since insuline can be less necesary so you need to just be careful of testing your cat and checking on him.

I feed Markies with raw chicken, cow, pork, bones, etc.. I also make a home made pate that I can share the recipie with you. You may want to follow Dr. Lisa Pierson's web site, she is the great reference for all of us as regards food. Her site is www.catinfo.org

I wish you the best and wheneer you need help just post here or in the group. I know that forum may be difficult, it was for me, but if you feel for some reason scared or whatever happen, and if you still didn't learn how to use the forum, just post in the group asking for help. With the time you will learn how to use it.

Last thing, try to make your cat come back for food during the day or find a way to feed him at least arround nadir, be creative. If you have someone traveling to UK there is a great product that scans our cat and only opens the feeder door when the right cat is in. Let me find it and post it here.

In the meantime, just stick to what the girls from the forum say, they are awesome and they know a lot!!!

Never use dry food, even if it says "Diabetic" and the vet say it's prescription diet. That's simply BS and your kitty's glucose will get to the sky. Plus, dry food is not apropriate for an obligate carnivore as the cat is. Just follow Dr. Lisa Pierson's site, you will learn a lot about how to feed a diabetic cat.

Good nights!!

Silvi

https://www.sureflap.com/en-us/pet-feeder/microchip-pet-feeder
 
@Chris & China
When he first came (he came begging for food in the beginning), i thought he is a girl, and since he is fat--shape like a Bell, so i started calling him Belle.

Is Evo dry (u mention in previous comments) better (lower carb) than DM dry? If so, i might wanna try it, i just checked, it's on sale now at chewy.com & pet360.com (6.6 lb bag $18). DM is so insanely expensive.

Yes, Belle usually goes outdoors during the day, otherwise he will cry until he gets to go out. and he is difficult to keep inside the house as well, he has the tendency to sometimes poop outside of the box. I now have a heater on in the garage at night, will warm it up, it has auto turn off, and i will turn it off b4 i sleep at night anyway (to avoid any danger).

If 1 unit is not enough, should i give him 2 units then?

I will be busy starting tomorrow and throughout the weekend, so might not be able to test him again until after the holiday.

btw, a little story, Belle and his sister Bailey (top left corner in the photo). their original owner came up to me about half a year ago, and said "Oh, these used to be my cats about 10 years ago, and i got a new dog, so they ran away...and it's ok, ...that they found you..." i was gonna tell her "NO, it's not ok, I have cats and dogs myself, and getting a new dog doesn't mean you can abandon your cats (and never go look for them, they both had been homeless and was hanging around in the neighborhood for quite some time b4 they came to me). and it is also putting time and financial burden on me! "
anywayz, according to her, Belle's original name was Cooper.
 
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icesnow said:
Is Evo dry (u mention in previous comments) better (lower carb) than DM dry?
Click to expand...

Yes...it's still not great but it's better than DM dry

icesnow said:
If 1 unit is not enough, should i give him 2 units then?
Click to expand...

No...we go up slowly, in .25 unit increments, never a whole unit at a time, but it IS possible that we might suggest going up to 2U if his numbers get really bad...especially since we know he's already been on 4U...it's just too early to know for sure

icesnow said:
"NO, it's not ok, I have cats and dogs myself, and getting a new dog doesn't mean you can abandon your cats (and never go look for them,
Click to expand...

Good for you for taking them in from this totally irresponsible owner!! I don't get it either....how do you just "throw away" a member of your family??:mad::mad::mad:
 
@Chris & China
Hi, i just checked Belle pre-insulin today @11am (his last insulin was given 1130pm last night, 2units), and his number is back up at 272. i gave him 2 units after the test. (sorry, i hvn't yet receive ur message when i gave him the insulin last nite). I will try to check him again throughout the day as much as possible, but can't do the full curve today since i hv family dinner n had to be out around 3pm.
hope the more testing will give more info for the right dosage. and what should i give him for now?

As for the canned food, should i give him DM or fancy feast? he gets both now.
 
Im sorry Im not the best for this since I don't live in your country but I will copy what Dr. Lisa Pierson's say

http://www.catinfo.org/#Prescription/Therapeutic_Diets_

" If you have decided to start feeding your diabetic cat a low carbohydrate diet, please do not change the diet until you review my Feline Diabetes page - especially the STOP sign section - otherwise you will be putting your cat in danger.

Please also be aware that many veterinarians underestimate the favorable impact that a low carbohydrate diet has on the insulin needs of the patient and they do not lower the insulin dose enough. If the insulin is not lowered accordingly, an overdose of insulin will occur which can be life-threatening.

I strongly suggest that all caretakers of diabetic cats home-test to monitor blood glucose levels using a standard glucometer as a matter of routine. Careful monitoring is especially important when implementing a diet change.

Many veterinarians prescribe expensive diets such as Purina DM (Diabetes Management) and Hill's m/d but you can do much better for your cat (and your pocketbook) by feeding other more nutritious - and lower carbohydrate - canned foods. See the Cat Food Composition chart. You should aim for a diet that derives less than 10% of its calories from carbohydrates.

The less expensive foods like Friskies, 9-Lives, and Fancy Feast are also fine to feed."

Hope this helps. Check her Feline Diabetes section at the link above.

Silvi
 
icesnow said:
@Chris & China
i checked her blood again at 130pm, her BG number is now 103
it was 272 at 11am, with 2 units of insulin given right after first check.
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I think you should keep on eye very close on him. YOu tested one hour an a half after shot time and he has a normal number.. If Im not wrong his clucose can go down, he didn't reach nadir. I will tell the girls on the forum so they can step in this forum now. Sorry, don't want to alarm but I think they should read this.
 
Are you still home and able to monitor for a little while longer? How long will you be out for? If Belle has continued to drop and you need to be out for a while, you might want to consider feeding a fair amount of high carb food to "abort" the cycle and make sure he stays safe. Will he free feed if you leave food out while you're gone?
 
Amy&TrixieCat said:
Are you still home and able to monitor for a little while longer? How long will you be out for? If Belle has continued to drop and you need to be out for a while, you might want to consider feeding a fair amount of high carb food to "abort" the cycle and make sure he stays safe. Will he free feed if you leave food out while you're gone?
Click to expand...
Amy she is not home unfortunately. BUt you can find her in the facebook. I already called her attention.
 
Is someone home keeping an eye on Belle? If so, that person could feed the high carb food. If she has a smart phone, she should be able to access the forum from it, too, so she can see what's going on here.
 
I would simply add that there are conditions that cause a cat to need higher than normal amounts of insulin. Yes it's possible your cat is on too high of a dose. It's also possible that he needs more than the average amount.

The way to find out which it is would be to get the information you have in the spreadsheet so we can take a look at it. I'm not a fan of blanket reductions of the dose - if he really needs more insulin than average, that can be a disaster. My own cat arrived here on 3u of insulin and several people suggested I reduce the dose, but instead I got more tests in and we determined that he NEEDED that much insulin. One if 4 cats does need more. Instead, I would call the vet, get all the test information you can from the curves that were done, note on the spreadsheet what the insulin dose changes were, and let us take a look at it.

Since he's out during the day and you can't test him then, you would want to either do a curve once a week - keep him in the garage for the day and test him every 2 hours for 12 hours or every 3 hours for 18 hours.
 
Oh, and you're not getting blood because the capillaries haven't grown yet. As you poke him, it will stimulate the growth of more capillaries. After a couple of weeks you'll get blood every time - in the meantime, hang in there and keep trying. You're still doing some good with it.
 
103 is still a normal number and if I'm reading the times right, it was 272 at AMPS (at 11am) and 103 at +2.5 (1:30)?

That's a pretty big drop for so early...if you have someone who can feed Belle, have them feed him something higher carb than DM or Fancy Feast since you can't be there to test

The wet D/M is low carb but it's no better in quality than the Fancy Feast (and a lot of cats get tired of it)...it's also very expensive for what it is. It's the DRY D/M that's high carb
 
Thanks everyone!!
I just got home and will catch up reading the comments above.
sorry, i was not able to access the forum when i was out, i was either driving or at family dinner.

@Chris & China
I just tested him again @ 9:15pm, and his BG is at 249, with his last insulin give at 11am, his per-insulin number was 272, and @ 1:30pm, his number was 103.

He is due again for insulin tonite at around 11pm, what dosage should be given to him?

@Amy&TrixieCat yes, he had the dry DM bowl available to him while i was gone.

@Silvina Thank you

@julie & punkin (ga)
He is out mostly during the day, but he mostly stays in the yard now, so most of time i can find him and test him. but if i intend to test him, i will mostly choose to keep him in the garage.
 
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As long as you can test tonight, I'd go with the 2U again

Don't forget to put the numbers into your spreadsheet...do you understand how to use it?

The AMPS is the AM Pre-shot (test immediately before feeding/shooting in the morning) and then we use the "+ system" since we're all over the world here and your 10am isn't necessarily my 10am

+3 is 3 hours after the shot...+5 is 5 hours after..+9 is 9 hours after..etc.....until you get past +11 and then you're at PMPS (PM Pre-shot) and the whole thing starts over

The spreadsheet color codes itself, but if you put numbers in at a time other than an exact hour (like +2.5) you'd put (for example) 103 @ +2.5 in the "+2" cell and then click on the little icon at the top that looks like a bucket of paint tipping over. Choose the color that goes with that number....in this case, the blue

Of course in the U column is the number of units of insulin
 
@Chris & China
I can probably test him again b4 i give him insulin tonite, but will go to bed soon afterward, so won't be able to test him again 2 hrs after.

i will figure out about the spreadsheet.

sorry, things had been overwhelming recently. my most beloved cat passed away couple weeks ago to pancreatitis, and vet's wrong treatment. another cat was just diagnosed with hyperthyroidism. and belle's sister is also having a limping leg... i m emotionally exhausted.
 
Can you at least set an alarm and get a test at +2?

That can tell you a lot about if it's REALLY important to test later in the cycle or if you can probably go to bed without worry
 
OK, maybe i can give him his insulin now, and test him in a couple hours. he usually gets it 1030 at night anywayz.
 
Most cats go lower at night...I'd just really hate for him to go too low when you're not able to test and help him if he gets too low

How long until his PMPS?
 
Well you don't want to give it too early either....Lantus really craves consistency and needs to be as close to every 12 hours as possible BUT if he's high enough, it can be OK to give early

We generally try to keep our shots at every 12 hours....and if we need to adjust, do it 15 minutes per cycle so it doesn't cause too much of a problem
 
i gave his insulin to him @ around 1015pm, and his BG was 249 @ 915pm (call it PMPS?). and will test him again quarter pass midnight.

now i hv to give medication to my 2 chinchillas... yes, i hv 2 chinchillas on long-term medications as well... :~(
 
Helena,

When are you going to be able to do a curve?

I usually do it at least for one cycle (12 hours) testing every 2 hours.

That will tell you how your cat is doing with that dose of insuline. Also will tell you at what time he has his nadir (the time when the insuline has it's strongest effect, this will be shown by the lowest glucose number during that cycle). Whenever you know when is his nadir you need to be able to feed him for sure, arround that time.

I guess you should keep giving your cat 2 units every 12 hours. Testing everytime you dose (AMPS and PMPS) and asap making a curve to see if that dose is correct for him.

The rest will help you better with this.

REMEMBER SOMETHING VERY IMPORTANT. Never dose before +12. If you dosed at 13:00 hs. (1PM) then you dose at 01:00 (1AM) never before that time, unless someone tells you to do it and how (there is a protocol to follow whenever you need to dose before +12).

Hope not to creat confusion with my bad English.
 
ok great, keep track of this testings and complet the spreadsheet.
let us know if there is two digits number or high numbers for example (more tan 400) so the fórum can see and help you through.

usually we write down the tetings in the spreadsheet so we can all see what is going on. Messages isolated in the thread may not help see his glucose behavior so if you can, complete the ss. It saves automatically and we can see almost online.

You want to try now so i can tell you if it Works?
 
Ok if you can't do the curve but you are able to test at least once in the cycle, try to test at +6 (instead of +2) or + 5
othe day at +7

this is better than +2 since Lantus has nadir arround +6

Happy Thanks Giving!!!
 
I see you upped the dose tonight to 2.5, I assume based on the pink preshot. The thing about lantus, being a depot insulin, is that you never adjust the dose based on a preshot number. Lantus (and levemir) doses are based on how low the dose is taking the cat not on preshot values.

Now that you have your spreadsheet set up I would encourage you to start posting in the lantus/levemir support group forum which is where all the experienced lantus users hang out. We will help you and the very gorgeous Belle get on track with all this :)
 
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